US Paramedic Skills

[crazylegs]

Afternoon all,

Does anyone know where I might find any documents that show the skills/drugs that US paramedics have and can use? I can't find anything myself but not knowing where to look hampers me a little.

[Kittish]

Wikipedia has a list of some of the basic stuff that paramedics all over the world do.

http://www.ems.gov/education/nationa...ardandncs.html might have more specific information regarding what's required for paramedics in the US, but I can't seem to see any of the links (all go to .pdf files).

I'll also ask a friend of mine who is an EMT next time I see him.

[trailerparkmedic]

It can vary WIDELY by state. I'd suggest starting with either NREMT, a national group that has an exam a lot of states require to show that you know what you're doing, or with the state department that licenses EMTs/Paramedics.

Edit: I also know that it can vary based on where you work. My hospital system employs paramedics that are able to do different things than the fire department's paramedics. I think that has to do with organizational regulations and not their actual skill set, though.

[kpzra]

Yup, NREMT does the testing, but it is up to each state, county, city, or company you work for as to what you can actually do. You'd have to narrow it down a bit for us to help with more specific info as in places like Michigan it can vary from county to county as to what is allowed. Then there are states like Alaska that don't use any national registry, they have their own system.

[Sapphire Silk]

Even with medics that are on the National Registry, it varies widely by service area.

Every service has a medical director, a physician, who writes their Standing Orders. These docs pretty much follow standard protocols, but can vary them based on their own tastes and preferences when it comes to the practice of medicine.

As long as the medic follows those protocols, he's good to go. He can't deviate from them without a verbal order over the radio.

[kpzra]

To add to that, even if your Standing Orders say you can do X, the company you work for may say "nope, we don't want you doing that". I Michigan some counties (but the next one over might not) allow Paramedic to do crics, but the company I was with said they did not want their medics doing them. Some counties also allowed RSI, some didn't.

I guess long answers short, there really isn't any one set of rules we have to follow for all of the US.

[trailerparkmedic]

Oh, and drugs are crazy different between organizations. One of the main things that my hospital system's paramedics do is transport stroke and heart attack patients from the smaller hospital to the bigger hospital for advanced treatment. One of the ER RNs at the smaller hospital started listing off all the drugs they MUST start their transport patients on, and my head nearly exploded that a paramedic is allowed to handle so much. Basically, they have little ICUs careening down the freeway. The fire department paramedics don't do that, but they are fantastic at scraping you off the freeway and doing a bunch of skills to keep you alive until the hospital.

Look up flight paramedics if you want an extreme version of skills & drugs that can be given. I understand that they have the most freedom.

[crazylegs]

Thanks all for your help guys

You'd have to narrow it down a bit for us to help with more specific info as in places like Michigan it can vary from county to county as to what is allowed. .

Ah - the reason why I've asked is there is a chance my G/F might end up working in the states at some point but at the moment we have no idea where in the US it might be and as I'm currently halfway through my first year of my paramedic training (it's two years here) I'm doing some gentle digging to see if I'll end up hugely deskilling myself or whether it's comparable (JIC anyone wants to have a look the current national standards for the UK are here http://www2.warwick.ac.uk/fac/med/re...ite/guidelines although they're due have a massive update released any time now).

ETA

In the UK paramedics are autonomous practitioners and can make independent decisions for patient care - I'm guessing that it's not so much like that in the US in all places..?

[emt_cookies]

I can send you a copy of my fire department's protocols and drug list. You have different drugs in your protocols.

Like everything can differ from department to department. Like where I train for my medic they have county drug boxes whereas in my state we stock our own.

Paramedics kind of do that but not always. Like I can decide to intubate my patient if it falls into the protocol but if I want to rsi them, then I would have to call and get permission to paralyze them.

[Sapphire Silk]

In the UK paramedics are autonomous practitioners and can make independent decisions for patient care - I'm guessing that it's not so much like that in the US in all places..?

Paramedics are not independent practitioners in the US. They carry their own certifications, but must remain within their protocols. If the problem falls outside those protocols, they must get direction from the MD.

Skills wise, though, you're probably good to go. The skills don't differ that much. Just the scope of practice. I'm not sure how you would go about getting on the national registry in the US. But UK nurses can apply for US licensure (they have to take the NCLEX RN first), so I'm sure there must be a process.

[crazylegs]

I can send you a copy of my fire department's protocols and drug list. You have different drugs in your protocols.

That would be great if you could

But UK nurses can apply for US licensure (they have to take the NCLEX RN first), so I'm sure there must be a process.

Cheers - should we end up moving (as it'll only be for a few years on a placement) I'll end up with even more digging to do I'm sure!